在经过微创手术对直肠癌进行横向淋巴结解剖后,经过微创手术后的泌尿功能障碍
Makoto Takahashi1, Kazuhiro Sakamoto2, Hisashi Ro2
1Department of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan. mktakaha@juntendo.ac.jp.
BMC surgery
|December 23, 2024
概括
对于直肠癌,机器人辅助手术 (RALS) 和腹腔镜手术 (LS) 在横向淋巴结解剖 (LLND) 后显示出类似的尿路功能障碍率. 双边LLND和手术部位感染 (SSI) 是长时间导管治疗的关键风险因素.
科学领域:
- 在瘤学瘤学.
- 手术创新 在外科创新.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 侧淋巴结解剖 (LLND) 对于局部晚期直肠癌 (LARC) 至关重要,以减少复发,但存在尿路功能障碍的风险.
- 像腹腔镜手术 (LS) 和机器人辅助LS (RALS) 这样的最小侵入性技术越来越多地用于LARC手术.
研究的目的:
- 为了比较术后泌尿功能障碍之间的LS和RALS后LLND为LARC.
- 在LARC患者中确定与LLND后长时间尿道导管治疗相关的独立风险因素.
主要方法:
- 一项对100名接受LS或RALS并LLND的LARC患者的回顾性研究.
- 术后泌尿功能障碍的评估是通过尿导管治疗的持续时间 (DUC) 来评估",长期"被定义为>5天.
- 分析了临床病理因素和手术细节,以确定DUC的预测因素.
主要成果:
- 在LS和RALS组之间没有观察到尿路功能障碍的显著差异.
- 与单边LLND相比,双边LLND与显著更长的DUC有关.
- 手术部位感染 (SSI) 独立增加了长时间尿道导管治疗的风险.
结论:
- 无论是LS还是RALS都没有在LARC的LLND后预防尿路功能障碍方面表现出优势.
- 双边的LLND和外科手术期间的SSI是长期尿道导管治疗的重要危险因素.
- 建议选择性,主要单边的LLND和强有力的SSI预防,以保持尿功能.
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